DERICK W MOODY (PA) – Psychiatric/Mental Health Clinical Nurse Specialist, NPI 1235551409
Psychiatric/Mental Health Clinical Nurse Specialist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,972 PHYSICIAN ASSISTANT in UT
Provider Addresses for DERICK W MOODY (PA)
672 W 400 S
STE 201
SPRINGVILLE, UT 846633170
Phone: (801) 812-4673
Fax: (801) 418-0941
Type: Mailing
672 W 400 S STE 201
SPRINGVILLE, UT 846633170
Phone: (801) 369-8989
Fax: (801) 704-9741
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 191 Open Payments records for all available years, with a total value of $3,580.
Total Amount is formed as General ($3,580) + Research ($0) + Ownership ($0) = $3,580.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($485).
Total Amount
$3,580
General + Research + Ownership
Payments
191
Total payment records
General Amount
$3,580
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Pharmaceuticals, Inc | $485 |
| Teva Pharmaceuticals USA, Inc. | $468 |
| Otsuka America Pharmaceutical, Inc. | $431 |
| ABBVIE INC. | $369 |
| Axsome Therapeutics, Inc. | $218 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-03-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140310000718 | I | Physician Assistant | UT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 69 | 29 | $0 |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 66 | 29 | $0 |
Insurance plans in this area (ZIP 84663)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | UT | 90833 | Psychotherapy, 30 minutes with patient and/or family member | 23 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | UT | |
| Nurse Practitioner | DE | |
| Physician Assistant | MI | |
| Clinical Social Worker | UT | |
| Physician Assistant | UT | |
| Nurse Practitioner | UT | |
| - | UT | |
| P S Y C H I A T R Y | UT | |
| Clinical Social Worker | CO | |
| Clinical Social Worker | UT |
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